[Aneurysms of the extracranial part of the carotid artery]

The purpose of this article is to take firm position on the surgical treatment of the carotid artery aneurysm on the basis of ten years of experience, considering their rare occurrence and significant pathology. From January 1984 to December 1994, ten patients with aneurysms or pseudoaneurysms of extracranial carotid arteries were diagnosed and operated in the Department of Vascular Surgery, Clinical Hospital "Sestre milosrdnice" in Zagreb. In the same period, eight hundred operations of extracranial carotid arteries were performed. Special emphasis is put on the etiology of the disease where atherosclerosis is prevalent, but cases of traumatic, mycotic and postoperative aneurysms are also shown. In symptomatology, signs of palpable local tumor dominated in six patients, while in three patients central nervous system symptoms were found. All patients with neurologic symptoms were in the group with atherosclerotic aneurysms. In nine patients resection of the aneurysm and reconstruction with the interposition of a part of vena saphena magna or with allograft was performed. In one patient, neoanastomosis of the internal carotid artery in the common carotid artery was performed following the resection of a small aneurysm. In the early postoperative period there was no morbidity nor mortality. In view of frequent preoperative neurologic complications and good postoperative results, surgical treatment is indicated in all cases. Reconstruction is always indicated, and the procedure of choice is reconstruction with the interposition of a part of great saphenous vein.